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Home / Health & Science

20 million NHIF members to miss medical services

HEALTH & SCIENCEBy ALLY JAMAH | Tue,Feb 09 2016 00:00:00 EAT
By ALLY JAMAH | Tue,Feb 09 2016 00:00:00 EAT

 NHIF CEO Simeon Ole Kirgotty meets health committee over new NHIF rates

About 20 million members of the National Health Insurance Fund (NHIF) and their dependents will not be able to access outpatient services.

NHIF said yesterday that the members were locked out after they failed to choose their preferred health facilities last month.

Only 945,640 principal members and their 1.3 million dependents responded within the NHIF deadline of January 15 to choose the facilities.

This means that the rest, including 4.5 million principal members, will not be be able to access outpatient services despite making contributions.

Currently, at least 5.6 million NHIF principal members are eligible for the outpatient medical cover. The number rises to more than 25 million when their dependents are factored in.

NHIF CEO Simeon ole Kirgotty told The Standard yesterday that without members choosing their preferred facilities, it would be impossible for the insurer to send money to health providers to offer services.

The outpatient cover is run under the capitation model in which NHIF provides Sh1,200 per year to accredited facilities for every principal member together with their five dependents.

Mr Kirgotty attributed the anomaly to misconceptions about the outpatient cover.

“We have been doing a lot of campaigning in the media urging members to choose their preferred facilities but the response has been low. We will scale up our campaigns,” he said.

He said that many Kenyans confuse between in-patient and outpatient cover.

NHIF Director of Strategy, Planning and Marketing Nicodemus Odongo said that those who missed selecting their preferred facility have to wait until April this year when the next window for registration or changing facilities will be reopened.

The Kenya Association of Private Hospitals, which brings together about 400 small and medium-sized hospitals, has raised questions about the policy of asking people to choose their preferred facilities.

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